Provider Demographics
NPI:1184381311
Name:ROSALES NUNEZ, MARIA SANDRA
Entity type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:SANDRA
Last Name:ROSALES NUNEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:MARIA
Other - Middle Name:SANDRA
Other - Last Name:ROSALES NUNEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:18951 SW 106TH AVE STE 105-106
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33157-7668
Mailing Address - Country:US
Mailing Address - Phone:305-233-4448
Mailing Address - Fax:305-760-4704
Practice Address - Street 1:18951 SW 106TH AVE STE 105-106
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-7668
Practice Address - Country:US
Practice Address - Phone:305-233-4448
Practice Address - Fax:305-760-4704
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-22
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician